Last psych appt

Yesterday afternoon I was seen by the doctors, and my community nurse/case manager also sat in on the meeting. I was asked whether I wanted to be discharged that day or the next, I chose to be discharged that afternoon. Though I still wasn’t great, I at least felt a little better than when I came in and I guess there wasn’t much point in staying any longer. We also discussed my medication, I still remain on 200mg of Pristiq and 50mg of Seroquel XR but have also commenced on 450mg of lithium as a mood stabiliser. It was either lithium or sodium valproate, but according to the doctor the latter has a greater chance of hair loss, weight gain and sedation occurring as side effects.

Spent this morning in tears as I emailed a uni lecturer about something totally unrelated, and in her reply she again brought up an incident last year which resulted in a general miscounduct and me getting into a whole load of trouble. It feels awful that I continue to have that held against me by a lecturer I will again have this semester despite me completing the disciplinary action that was dealt to me and having damn well learnt my lesson. I then attended the last session with my psychologist at the eating disorders program in which I cried some more both talking about this situation with my uni lecturer, and then saying I felt “A bit sad,” when she asked me how I was feeling about it being the last session. It’s the first time I’ve ever admitted to feeling anything other than indifference towards any psychologist I’ve seen as I’ve always been ashamed of feeling attached to or having any emotional connection to others, especially when it’s not reciprocated. Though it wasn’t easy attending knowing it’s my last appointment, I’m glad I did and handled it much better than I did the last time I had to change psychologists. It’s quite embarrassing when I remember how I spent the second last session crying, refused to come back for another session or to see the psychologist I was being transferred to, overdosed and ended up in hospital thus never having a proper concluding session, then wrote him an angry email about how useless therapy is.

I’m starting DBT next week with the group component running on Tuesdays and my first individual therapy session is on Thursday. I’m really nervous about DBT and how full on and strict it seems. At the end of my assessment sessions for DBT I was given a contract and asked to sign it, with rules such as not being allowed to miss a certain number of group or individual sessions, having to complete the homework, rules around interactions with other clients and your therapist not having contact with you for 24 hours if you’ve self harmed. I also have a lot of ambivalence about whether I really do want to change and to stop self harming or not, and so much fear when I think about doing so. Plus I’m hesitant about starting all over again with yet another psychologist knowing that if I do develop a connection it will feel like another loss when we have to cease therapy, especially after weekly appointments for a year. 

Have you self harmed?

One of the things I dislike in therapy is when a psychologist asks how many times I’ve self harmed that week. Okay, I can kinda see how it’s relevant to gauge whether I’m still self harming or not. From their point of view, it means I’m still engaging in risky, self-destructive behaviours and therefore is an issue that still needs to be worked on. But at the same time, is it really that helpful to put so much focus into it? In my mind, it reinforces the belief that the only way to communicate how I’m feeling on the inside is to physically harm myself on the outside.

A topic that has come up in my appointments with D is rejection; how much  fear it, how much it upsets me, how much I try to avoid it. There is a fear within me that if I report I haven’t self harmed, the professionals will automatically assume everything’s okay. I am afraid of rejection and I am afraid that I will be told at one point or another that I don’t need to continue seeing them any more because I’m ‘cured’.

There’s been a few times D has asked me to record down when I’ve self harmed during the week for homework. I’ve never done what he’s asked. I don’t believe it will do me much good and may even trigger me more by making me think I have to self harm to prove I deserve help.